title: The value of usability testing for Internet-based adolescent self-management interventions: "Managing Hemophilia Online".
abstract: BACKGROUND
  As adolescents with hemophilia approach adulthood, they are expected to assume responsibility for their disease management. A bilingual (English and French) Internet-based self-management program, "Teens Taking Charge: Managing Hemophilia Online," was developed to support adolescents with hemophilia in this transition. This study explored the usability of the website and resulted in refinement of the prototype.
  
  
  METHODS
  A purposive sample (n=18; age 13-18; mean age 15.5 years) was recruited from two tertiary care centers to assess the usability of the program in English and French. Qualitative observations using a "think aloud" usability testing method and semi-structured interviews were conducted in four iterative cycles, with changes to the prototype made as necessary following each cycle. This study was approved by research ethics boards at each site.
  
  
  RESULTS
  Teens responded positively to the content and appearance of the website and felt that it was easy to navigate and understand. The multimedia components (videos, animations, quizzes) were felt to enrich the experience. Changes to the presentation of content and the website user-interface were made after the first, second and third cycles of testing in English. Cycle four did not result in any further changes.
  
  
  CONCLUSIONS
  Overall, teens found the website to be easy to use. Usability testing identified end-user concerns that informed improvements to the program. Usability testing is a crucial step in the development of Internet-based self-management programs to ensure information is delivered in a manner that is accessible and understood by users.
authors.affiliation: Division of Hematology/Oncology, Department of Pediatrics, McMaster Children's Hospital, 1200 Main Street West, Hamilton, Ontario, L8N 3Z5, Canada. breakev@mcmaster.ca.
authors.forename: Vicky R
authors.initials: VR
authors.lastname: Breakey
authors.forename: Ashley V
authors.initials: AV
authors.lastname: Warias
authors.forename: Danial M
authors.initials: DM
authors.lastname: Ignas
authors.forename: Meghan
authors.initials: M
authors.lastname: White
authors.forename: Victor S
authors.initials: VS
authors.lastname: Blanchette
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Stinson
mesh_terms: D000293:Adolescent; D019468:Disease Management; D006467:Hemophilia A; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D009864:Ontario; D010353:Patient Education as Topic / Q000592:standards*; D017060:Patient Satisfaction; D036301:Qualitative Research; D011792:Quebec